Individual
KRYSTAL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
312 WHITTINGTON PKWY, SUITE 020, LOUISVILLE, KY 40222-4923
(502) 429-1249
Mailing address
312 WHITTINGTON PKWY, SUITE 020, LOUISVILLE, KY 40222-4923
(502) 429-1249
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/19/2017
Last updated
01/19/2017
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